Is ‘blackish pigmentation on the neck, underarms’ a sign of increased diabetes risk?

Often, signs of an internal body issue get reflected externally.

As such, Health Hatch, a nutrition company, recently shared a video saying that skin tags or blackish pigmentation on the nape of the neck, and on the underarms could be associated with increased insulin resistance, and thereby diabetes risk.

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“Have you noticed small growths also called skin tags, blackish pigmentation on your neck and underarms? There are high chances you might be at risk for diabetes. Skin tags and pigmentation on the neck are closely associated with insulin resistance which can further put you at risk for diabetes. Skin tags are also related to high triglycerides in the blood which again is associated with diabetes and heart diseases,” the post read.

According to a comment on the post, the condition can affect even young people and is most common during pregnancy. “Genetics play a role, but so does lifestyle. Your lifestyle can/will aggravate insulin resistance more,” the page said in response to a user’s question.

Agreed Dr Yuti Nakhwa, consultant dermatologist and cosmetologist at Global Hospital Parel, Mumbai and said that the condition called Acanthosis nigricans “causes thick dark velvety skin along the body creases”. “Commonly seen around the nape of the neck, underarms, and inner side of the thighs. Acanthosis nigricans is commonly associated with obesity, and insulin resistance which is most commonly seen in type 2 diabetes and polycystic ovarian syndrome,” Dr Nakhwa told

Insulin resistance occurs when insulin receptors’ impaired sensitivity to insulin leads to compensatory hyperinsulinemia (or more insulin) in the blood. “Insulin stimulates glucose uptake, increases lipogenesis, and inhibits lipolysis, thus leading to increased risks of diabetes and increased lipids in the blood, especially triglycerides. Insulin also stimulates keratinocytes and melanocytes, thus giving dark skin and skin tags. Hence early detection of insulin resistance in patients may play an essential role in preventing further health complications,” said Dr Kiran Godse, dermatology and cosmetology, Hiranandani Hospital, Vashi-A Fortis Network.


The doctor will always suspect insulin resistance in a patient with acanthosis nigricans, said Dr Nakhwa. “They may ask you to undergo blood tests to rule out diabetes, polycystic ovarian syndrome, or thyroid abnormalities,” the expert said.

Is it dangerous?

One skin tag shouldn’t be of a concern unless it grows or is accompanied by darkening of neck/underarms, said Dr Singh.

underarm It is important to check for any pigmentation on underarms (Source: Getty Images/Thinkstock)

Is it a concern in young children?

“This is common in obese children, especially in the age group of 6-8 years, and is a warning for implementing better lifestyle habits,” Dr Singh asserted.

Does it happen in pregnancy?

Dr Nakhwa responded in the affirmative and said, “Acanthosis nigricans is observed during pregnancy due to hormonal changes which subside after delivery and reduction of weight”.

What can be done?

Dietary habits like consuming processed, refined food items like maida, refined flour, oil, sugar, and excess of animal products like dairy, meat, and poultry can decrease the body’s response to the insulin that is secreted, said Dr Smriti Naswa Singh, consultant dermatologist and cosmetic dermatologist, Fortis Hospital, Mulund.

However, since it is a “reversible condition”, lifestyle changes can help. “You have to maintain a healthy weight, eat balanced meals, exercise regularly, work on your stress and sleep,” the page posted. Dr Nakhwa agreed and said that the most effective treatment is to “reduce weight, exercise regularly and manage underlying cause like polycystic ovaries or thyroid”.

Reduction of non-processed foods, avoiding junk, and focusing on a whole plant-based diet is a must, Dr Singh said. “Children should follow a 60-90 minutes exercise routine, including running, sports, dancing, etc, daily. Adults should do 2.5 hours of exercise every week, follow proper sleep habits, eat healthy meals, and limit the use of gadgets,” Dr Singh advised.

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